Consulting case studies

Case examination and decision making workshop for the Agency for Medical Responsibility, Kuwait

We held a three-day workshop at our office in Manchester, UK, to share our knowledge around the handling of complaints made against healthcare practitioners. Particular focus was on case examination and decision making, from a case investigations perspective. As well as assessing evidence and making final decisions in relation to complaints made against healthcare practitioners.

The Agency for Medical Responsibility (AMR), Kuwait, has the sole responsibility for addressing concerns about healthcare practitioners in Kuwait. It was formed in 2022 with the sole purpose of investigating complaints made against all healthcare practitioners within the country.

Our goal was to provide a workshop sharing our extensive experience in this field to support AMR in its case examinations, tribunal structures and decision-making skills. This important subject matter is essential to determine outcomes that are deemed to be fair to all healthcare practitioners who have had a complaint made against them.

"At AMR, we are dedicated to upholding the highest standards and best practices in our field. It was an obvious step to turn to GMC's renowned expertise, which is rooted in the UK's legacy of evidence-based healthcare practices. This insightful workshop has expanded our knowledge and brought added depth to our established practices and procedures. Our previous engagements with GMC have been very fruitful, and we look forward to expanding our collaborations even further in the future." — Dr. Salman Al-Sabah, President of AMR

The workshop was presented by subject matter experts, sharing our processes in an interactive and engaging way.

Attendees learned about:

  • thresholds for investigation and how to collect evidence
  • the importance of consistency
  • impartiality and transparency in decision making
  • skills required to draft a good decision.

The materials were presented using a combination of presentations, case studies and group exercises, which the attendees found very useful.

The workshop prompted interesting discussions around the case examination processes and comparisons were made between those of ourselves and those of AMR.

Observing the parallels between AMR's methodologies and those of our own, underscores an alignment in values and dedication to healthcare excellence and reflects a common goal to elevate healthcare standards. This sharing of processes led to helpful discussions around best-in-class case examination methodologies, taking local context into consideration.

Attendees were awarded with a certificate confirming their attendance and participation in the GMCSI’s case examination and decision-making workshop.

Healthcare systems strengthening project

GMC Services International (GMCSI) was selected to lead a team of British subject matter experts for an ODA-funded project. The project was focused on strengthening the health workforce through education and training. With specific focus on using a preventative approach, especially when it comes to addressing healthcare challenges around non-communicable diseases (NCDs).

We were the main UK contact for the client, providing overall project management and the management of project logistics. Subject matter experts sharing their insights and expertise were from the GMC, Imperial College London (ICL), the Royal College of General Practitioners (RCGP) and two independent nursing consultants.

Together with ICL, we provided guidance and shared knowledge in all areas to do with the integration of primary healthcare competencies into medical curricula and standards. Their subject matter experts held workshops to share expertise on encouraging medical doctors to engage in continuing professional development (CPD) to remain fit to practise. CPD should be done in a meaningful way. I.e. it should be linked to the medical doctors’ work, plans and ambitions.

The workshops also covered licensing, certification and recertification mechanisms for medical doctors. And shared the UK approach to stimulate some thinking as to what the future of these areas may look like. We also shared their process of conducting medical school assessments. To make sure that the necessary standards and outcomes of medical education are being upheld.

Two independent nursing consultants led the workstream to strengthen nursing training. Providing guidance and expertise on the introduction of the advanced nursing role, which was still in its infancy.

This sharing of subject matter expertise was a successful formula and they commissioned further consulting work to continue some of the workstreams.

Restructuring a medical council 

A health council felt that their current structure was not allowing them to deliver against their objectives. They wanted to improve the way it regulated medical doctors. We analysed the current organisational structure and interviewed both internal and external stakeholders.

The stakeholders highlighted what was working and what they felt required improvement. After considering this important feedback and using our 160+ years of experience as a regulator in the United Kingdom, we made recommendations to make the organisation more effective through an organisational restructure. We also recommended they employ additional resources to reduce the time it was taking to process complaints made against medical doctors. 

Review of national medical school standards

We carried out a detailed analysis for an overseas Ministry of Health, on a set of proposed national medical school standards. Benchmarking them against global best practice. The purpose was to raise standards of medical education and training to enhance the country’s reputation as a centre of healthcare excellence.

We appointed a highly experienced and multi-disciplinary review panel to consider all relevant aspects of the standards. Reviewing every section and each individual standard at a detailed level. They conducted interviews with senior stakeholders of each of the medical schools to capture qualitative feedback on the school perspective. They then developed detailed findings and recommendations and grouped them by appropriate themes to form a basis for integrated implementation. The Ministry was able to proceed with implementing a set of standards across all its medical schools that were benchmarked against global best practice.

They also looked at workforce planning and the ongoing quality assurance of medical schools. They conducted a detailed analysis of the country’s medical education systems. Comparing existing process and practices against global best practice. 

Online payment system

We have the technology to enable medical doctors to pay their annual retention fees online. In some countries, this is still a manual process with fees being taken in the office and tracking done on an excel spreadsheet. We identified an online process that could be used on the regulator’s website to encourage electronic payments. This was more convenient for most medical doctors and saved them time of having to travel to the regulator’s office to make the payment.

Fitness to Practise legislation and processes and a new framework for Medical Tribunal Services.

GMCSI carried out a detailed review of the Fitness to Practise landscape in an overseas jurisdiction on behalf of the Ministry of Health. The review spanned legislation, investigation processes and tribunal hearings. With a view to improving the supply of doctors and the quality of care across the healthcare economy. The review highlighted the implications of regulatory shortfalls for patient safety, public confidence, and the supply of doctors. It made detailed recommendations to transform the current system to make it more effective and supportive of national healthcare strategy.

We provided support around complaints handling (complaints made against the healthcare professionals) for the setup of a new regulator of healthcare professionals. The consulting work for the new regulator focused primarily on the set up and development of fitness to practise rules and guidance based on national legislative requirements. The guidance focused on:

  • drafting decision outcomes
  • information handling
  • detailed triage decision making policy
  • indicative sanctions
  • capturing hearing practise notes
  • interim order guidance for referrals
  • drafting case reports for case examiners
  • pre-hearing case management and the writing of the fitness to practise publications policy.

Strategic review of an overseas regulator

We completed a comprehensive strategic review of an overseas regulator. Commissioned by the Minister of Health, we advised on the recruitment and retention of the doctor workforce.

We scoped the work with the Minister’s team and key stakeholders and carried out a literature review. Five key themes emerged, and these helped to shape the planning, delivery, and final outputs of the review. Subject matter experts interviewed senior stakeholders and doctors from several different organisations, as well as staff at all levels. They reviewed documentation against practise to triangulate the findings.

The final outputs were a set of recommendations and an implementation plan based on five strategic programmes. These will deliver a target operating model refined for the customer’s specific market. As a result of the review, the Ministry was able to move forward with reforms to the regulatory framework to optimise the supply of doctors and progress the implementation of its healthcare strategy.